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Hello I am Dr. Joey. Thanks for trusting me to help you and your pet today. I am a licensed veterinarian with over 15 years of experience. I look forward to working with you.
Usually the initial lab work would confirm diabetes (glucose higher than 400 and a high fructosamine level). Sometimes, however, our new diabetics have other problems such as underlying Cushing's syndrome (an elevated ALKP on lab work would make this suspicious) or serious infections. Was his urine cultured at time of diagnosis? This is usually something I recommend because these guys usually have a bad UTI.
Sorry about gender confusion; meant she.
If she continues to refuse to eat then this becomes an emergency and she must be seen tomorrow and evaluated to be sure she does not have diabetic ketoacidosis, which will require hospitalization.
Good thought to stop giving full dose of insulin if not eating well.
Please let me know what specific questions you have.
my vet has eliminated diabetic ketoacidosis .
She was tested for this yesterday? Great! Is the antibiotic new? If so, then this could be the culprit. If she was my patient I would recommend stop and see if her appetite returns within 24-36 hours.
could this be anything other than diabetes?
her appetite has not been good for about 2 weeks and she has been on the tablets for 4 days now
Yes. It is always possible that this unwillingness to eat may be something else. But elevated blood sugar if the above parameters were met is due to diabetes mellitus. If the elevated glucose was not higher than 400 and a fructosamine level was not run, then this may not be diabetes.
Unwilling to eat is not usually a sign of diabetes; more the opposite. I have had the rare diabetic that won't eat and they often required hospitalization for IV fluids and electrolytes to correct imbalances before we got things under control.
Are you giving anything for appetite/nausea (I assume so); at least famotidine?
i thought that cushins made them eat more.
It usually does but if a dog has a double problem of diabetes and hyperadrenocorticism (Cushing's) then they could be quite ill with a secondary infection or another problem related. These guys are very tough to manage, but your vet should have mentioned this and would have been clued in because the AlKP in lab work is super high. If this was not mentioned, then probably not a worry.
we have tried everything to try and persuade her to eat. chicken,liver,beef.dried food, wet food,porriage biscuits,bonios etc
Great job tempting her to eat. She is probably going to require medication to address nausea or an appetite stimulant. You are always welcome to try famotodine which is available over-the-counter as a stomach acid reducer (you could use the 10mg twice daily). No bad side effects. But for more powerful anti nausea or an appetite stimulant will require a prescription from your vet.
I am super worried with her being a diabetic and not eating. This usually means, even if not DKA, then there is something else quite significant going on such as cancer or another organ issue. I would advocate an ultrasound of her pancreas to look, and X-rays if not already done as a full body scan. :(
thank you for your advice we will take her back to the vets tomorrow and hope to get her sorted..
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